Ambulance for Neelum Valley

Project Proposal On Ambulance for Neelum Valley
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Provision of Ambulance for the vulnerable people of  Union Council (UC) Gurase Valley

Provide24/7 ambulance service for the vulnerable people of UC Gurase Valley in District Neelum.

Union Council Gurase, Tehsil Sharda, District Neelum, Azad Jammu & Kashmir

Gurase Valley the most captivating but remote and backward area which is located in District Neelum Azad Kashmir at a Longitude of E 74 “33’ 56.0962” and Latitude N 34 “48’ 45.633” covering an area of 52,817 ha, lying between 2,017m to 4,345m elevation. The area is situated at line of control (LOC) at height of 10000-14550 Ft between India and Pakistan. It is bounded by the Astore (Northern Areas) to the North, with Indian Occupied Kashmir to the South and Southeast, Muzaffarabad District to the Southwest and Kaghan Valley to the West. It has population of 38,428 (25,000 population in 2007 UNICEF survey) individuals and consists of 36 villages and 8 wards. The area is very beautiful having abundant of Natural Resources (Forests, Wild Life, Glaciers, Lakes, Water, Mushrooms, Medicinal Plants, Precious Stones) and have a great potential for tourism.SOCIO-ECONOMIC CONDTIONS: The socio economic condition of the majority community is poor. The community (88%) depending upon agriculture, livestock and seasonal labour work in neighborhood Big Cities for their livelihood. In the area no business or factory existed. Only 7% are engaged in Government & Army Service, 2 % in Private Job (in other cities), 3 % Business at micro level.COMMUNICATION & ACCESS: UC Gurase is 170 KM away from District Muzaffarabad capital of State Azad Jammu & Kashmir, 80 KM away from Authmuqam (District Head Quarter) Neelum and the road is un-mattled from Tehsil Sharda to onward. The local transport is Jeep / Toyota as here the travel is possible only on 4×4 Vehicle. There is no communication system (except three satellite PCOs), and in this Modern Technology era here the people use letters by post for communication.  The road is closed in winter during snow fall for almost 4 months.EDUCATION: Government of AJ&K is claiming that over all literacy rate in District Neelum is 50% while it’s less than 25 % in Union Council Gurase. If compared with overall literacy rate of AJK District Neelum has 71 % less Literacy Rate. While the literacy rate among females is below 11 % in the Union Council. There are not sufficient educational facilities in Gurase Valley, whereas Government has provided only 1 Girls High School and 2 boys High School, remaining schools are primary level in Gurase. Mostly schools (especially primary schools) still haven’t buildings. Furthermore the laboratories and other facilities are nowhere. The parents who can afford, their children have to go outside the valley for college and university education. The existed schools have no proper facilities, equipment and Laboratories. The shortage of staff and availability of competent teacher is a serious concern. The existence of library, extra curriculum and quality education is a question mark.

HEALTH: Health and hygienic condition of the valley is even much worse than any part of the AJK remaining 9 districts. There are only two Basic Health Units (BHUs) in the whole union Council which remain almost out of medicines. One BHU (Janawai) is lead by a Dispenser / Nurse, while in the other BHU (Halmat) an Army MBBS Doctor is providing services. For medical treatment of moderate to complex cases majority of the patients need to move to Muzaffarabad or Authmuqam which are 170 KM and 80 KM away from Gurase respectively. Majority of the patients are become more vulnerable due to absence of proper transportation facilities. Many cases have been recorded and reported where the patient died due to late arrival / approach to nearest hospital.

The situation becomes worse in winter season when the whole valley is ice-covered and temperature falls down from the freezing point. As the whole area is hilly people experience more difficulties while approaching / accessing hospitals of Kel & Authmuqam. Many patients especially women and children die during winter because of absence of medical facilities. Doctor or Lady Doctor and gynecologist are still not appointed by the government even in the whole district number of the women die during pregnancy complications. In short whole Neelum valley with population of 38,000 persons has no ambulance facility.

CASTE & CREED: Population of the Gurase is Sunni Muslim and is cluster of different tribes who speak Shina, Kashmiri, hindko and Gojri. Living a simple life, community is still attached with their culture, norms and history.

MICRO INFRASTRUCTURE: UNDP has worked in Gurase during 1997-99, it includes 2 Water Supply Schemes and 01 Hydro Power. While AJKCDP (IFAD funded Project) and PCRET have constructed 10 Micro Hydro Power Projects in UC Gurase. These were worse affected in the 2010 flood as well as Irrigation Channel, Village Paths, Bridges and Floor Mills. Some projects are rehabilitated by community through self-help basis. However there is urgent need to rehabilitate such valuable schemes.

VillagesNo. of HouseholdsTotal PopulationBENEFICIARIES
182,95638,42810,76012,681  14,987
Data Reference: Govt of AJ&K Statistics 2013, SDO Baseline Study 2014

Provision of health facilities / services is a big question mark in context of UC Gurase Valley. Health and hygienic condition of the valley is even much worse than any part of the world. There are only two Basic Health Units (BHUs) in the whole union Council which are remain almost out of medicines. Both the BHUs have an In-charge “Dispenser / Nurse”, however in BHU (Halmat) Army has deputed its MBBS Doctor to provide services for army & civilian. In winter season when the whole valley is ice-covered and temperature falls down from the freezing point, people could not reach to hospitals of Muzaffarabad, Kel & Authmuqam and rely on local herbs for treatment. The District Head Quarter hospital is 100 KM away from the Gurase Valley Community. Thus many people especially women and children die during winter because of absence of medical facilities. Doctor or Lady Doctor and gynecologist are still not appointed by the government even in the whole district so a number of the women have to die during pregnancy complications.A 65 KM long Valley with population of 38,000 persons has no ambulance facility. The road of Gurase Valley is un-metalled and has very bad condition. Only the 4×4 vehicles can be used for traveling here. Due to absence of emergency ambulance service an average number of 15 to 20 people die annually due to road accidents.During the rapid need assessment (RNA) in District Neelum; SDO identified UC Gurase Valley as the most vulnerable & remote area; deprived; having no support from government. There are several needs of community of UC Gurase identified, while prioritized the need of health and education. Keeping above mentioned grounds, SDO has planned to start Ambulance Service for the community of UC Gurase on priority basis in partnership with Donor and also Establish a 10-bed Welfare Hospital in near future.However through this project proposal, we are forwarding our request to donor & philanthropist for provision of an Ambulance for the community of UC Gurase; which may be able to provide 24/7 hours services.

SDO Field Team of District Neelum will be directly responsible for the operations of the ambulance. The ambulance will be placed at BHU Janawai, which is the central point of Gurase Valley approachable to rest of UC in quick response time. SDO will depute a driver for managing the vehicle with care. Driver will have a log book and the travel Request forum. On patient family request the Information Desk Officer will inform the driver who will be responsible to drop patient at the destination (DHQ Authmuqam, CMH Muzaffarabad, PIMS Islamabad etc). Both driver and desk information officer will be trained on first aid and emergency aid by SDO. SDO will also keep capacitating the ambulance team on need basis.The core competence of the SDO is strong networking and group of volunteers in District Neelum. For effective and efficient use of the resources SDO will utilize its volunteer groups and other networks to meet the challenges of poor communication and other hurdles. In each village SDO volunteer will be focal person to correspond with ambulance team. The village focal person will have complete information regarding the help desk which will be established in BHU Janawai. For communication purposes SDO will utilize its functioning communication system of walkie talkie. Also the desk officer in BHU Janawai will have liaison with 03 satellite PCOs functioning in the targeted UC. For public awareness raising SDO will display charts at central location in each village which will contain information regarding the walkie talkie.To meet the operational expenses of the ambulance and driver and desk information officer salary SDO will charge fuel expenses to patient family with nominal / marginal fee. The beneficiaries of the ambulance service will be categorized in 04 categories; those who have good income and can afford fuel expense, patient families with low to middle income and can partially afford the fuel expense and third categories of women headed and disable headed households.COST CHARGING CRITERIA
Category of BeneficiaryCharges
Rich Family100 % fuel with fee 500 PKR / Trip
Middle Income family100 % fuel charges with fee 50 PKR / Trip
Low Income family50 % fuel charges with no fee
Orphan, Women headed households and disable person headed householdsNo fuel charges and no fee

This ambulance service has potential outreach of 25000 people. The monthly estimated beneficiaries of the ambulance service will be 60-80. In total the population of 15000 – 20000 will be benefited from the proposed project.

1.      Local community has easy access to hospital using ambulance service.2.      Decreased health vulnerabilities by utilization of ambulance service and reaching hospital in time.3.      Women headed and disable headed households have 100 % free provision of ambulance service. .

1.      SDO will charge the fuel cost on the patient, which will cover its travel cost.For the sustainability of the ambulance service SDO will charge fuel cost to patient’s family with nominal fee having affordability capacity. The income generated from the fee will be utilized in drive and desk information salary.2.      SDO’s Pool funds will be utilized for the overhauling / maintenance of ambulance.SDO will also generate funds for ambulance service by collecting charity money from individual donors, businessmen. A special unit will be made which will collect funds (charity money) for the ambulance service. The majority of the fund 60 % will be reserved for the women headed households and disable headed households, poorest of the poor and rest 40 percent of the funds will be utilized for the operational cost (maintenance and repair of the ambulance).3.      SDO will charge some cost other than for the fuel cost. Please refer to the operations methodology for the details of cost contribution from the beneficiaries.

1.      Daily Vehicle Log Book2.      Travel Request Form3.      Annually report on the total beneficiaries, operations of Ambulance, Maintenance position4.      Surprise verification of beneficiaries on quarterly basis by SDO monitoring unit applying various techniques, physical meetings, phone calls.5.      Random correspondence with hospitals.

Toyota Hilux 4×4 Single Cabin Cost                                                                      Rs. 2,970,000/-
Air-Conditioning Options;
Dual A/C Unit for patient and driver cabin, Original Sanden
Compressor (Made in Singapore) with rear Formula blower unit                          Rs. 76,000/-
Total Cost of Fabrication including above Equipment (w/out GST)…..                  Rs. 665,000/-

Grand Total w/o GST                                                                                Rs. 3,711,000/-
(Please refer to attached Quotation)

The rates may very time to time depends upon the prevailing prices of the vehicle.



Please find the below link for the technical specification and quotations for the ambulance. Due to hard hilly area, we required the 4×4 vehicle. SDO logistics team has surveyed in the market, and after survey finds the Single Cabin Hilux pickup suitable for the area. This vehicle is economical as comparison to Toyota Company.

You can transfer money online directly at the following Bank.

Account Title:                                    Sustainable Development Organization
Account No:                                       0422-7901141603
Bank Name:                                       Habib Bank Ltd
IBAN No:                                            PK54HABB0004227901141603
Branch Address:                               Gillani Chowk Branch Muzaffarabad, AJK (PAKISTAN)

Khurram Jamal Shahid
Chief Executive, Sustainable Development Organization (SDO)
Contact No: (+92) 0300 9773466
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